V09-10 NEWLY ESTABLISHED APPROACH OF AN ENTIRELY RETROPERITONEAL ROBOTIC NEPHROURETERECTOMY

Abstract

You have accessJournal of UrologyCME1 May 2022V09-10 NEWLY ESTABLISHED APPROACH OF AN ENTIRELY RETROPERITONEAL ROBOTIC NEPHROURETERECTOMY Peter Sparwasser, Stefan Epple, Anita Thomas, Robert Dotzauer, Katharina Böhm, Maximilian Peter Brandt, Kamal Gheith, Rene Mager, Martin Kurosch, Hendrik Borgmann, Thomas Höfner, Axel Haferkamp, and Igor Tsaur Peter SparwasserPeter Sparwasser More articles by this author , Stefan EppleStefan Epple More articles by this author , Anita ThomasAnita Thomas More articles by this author , Robert DotzauerRobert Dotzauer More articles by this author , Katharina BöhmKatharina Böhm More articles by this author , Maximilian Peter BrandtMaximilian Peter Brandt More articles by this author , Kamal GheithKamal Gheith More articles by this author , Rene MagerRene Mager More articles by this author , Martin KuroschMartin Kurosch More articles by this author , Hendrik BorgmannHendrik Borgmann More articles by this author , Thomas HöfnerThomas Höfner More articles by this author , Axel HaferkampAxel Haferkamp More articles by this author , and Igor TsaurIgor Tsaur More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002617.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: While several surgical techniques have been established for both open and minimally invasive treatment of upper tract urothelial cancer (UTUC), the procedure of robot-assisted nephroureterectomy (NU) including excision of the bladder cuff has never been reported using only retroperitoneum. We developed a novel port placement and step-by-step technique allowing to perform robot-assisted NU by an unique retroperitoneal approach without relocation of the surgical robot. METHODS: Between February and June 2021 patients with history of UTUC and indication for surgery were treated by robot-assisted NU completely restricted to the retroperitoneal space using a singular trocar placement and a two-step docking without relocation of the surgical robot (DaVinci® Xi). Patient characteristics, perioperative outcomes and short-term follow-up were prospectively analyzed. RESULTS: This analysis included 5 patients [mean age: 67.4yr; BMI: 28.2kg/m2; Charlson comorbidity index 5.2]. All 5 patients had UTUC with a mean tumor size of 3.02cm (range 0.9-6.0). UTUC was thereby localized to distal ureter in 2 and to kidney in 3 cases. No positive surgical margins were noted for all patients with UTUC [1 low-grade and 4 high-grade]. Retroperitoneal lymphadenectomy in 3 patients did not reveal positive nodes. No intraoperative adverse events exceeding EAUiaiC classification ≥2 were observed, while EBL was 200ml (range 100-450). No patient experienced postoperative complications exceeding Clavien Dindo classification ≥3a. Median hospital stay was 5.4d without any 30d-readmission. CONCLUSIONS: We demonstrate safety and feasibility of the first entire robot-assisted retroperitoneal nephroureterectomy (RRNU) with bladder cuff. This surgical technique is easily reproducible, while surgical outcomes are similar to other established techniques. Prospective research is warranted in order to robustly evaluate its supposed benefits over transperitoneal approaches. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e807 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Peter Sparwasser More articles by this author Stefan Epple More articles by this author Anita Thomas More articles by this author Robert Dotzauer More articles by this author Katharina Böhm More articles by this author Maximilian Peter Brandt More articles by this author Kamal Gheith More articles by this author Rene Mager More articles by this author Martin Kurosch More articles by this author Hendrik Borgmann More articles by this author Thomas Höfner More articles by this author Axel Haferkamp More articles by this author Igor Tsaur More articles by this author Expand All Advertisement PDF DownloadLoading ...